Medscape UK report: More UK doctors oppose than support assisted suicide.

Alex Schadenberg
Executive Director, Euthanasia Prevention Coalition

The Medscape UK 2020 ethics report found that more UK doctors oppose assisted suicide than support assisted suicide. The Medscape report was based on online responses from 1355 UK physician.

The Medscape question asked:

Should physician-assisted suicide or 'physician-assisted dying' be made legal for the terminally ill - or for those who say they have irredeemable suffering, even if the disease may not be terminal for many years?

42% said No, 37% said Yes and 22% said it was a grey area. It is notable that 55% of the GP's said No.

Dr Gordon Macdonald

Dr Gordon Macdonald, Chief Executive of Care Not Killing commented, in March 2020 on the Royal College of General Practitioners decision to uphold their opposition to assisted suicide by stating:

'Just look at what is happening in Canada, which introduced assisted suicide and euthanasia in 2016. Since then around 13,000 people have been killed. Then in September, the Quebec Superior Court struck down the requirement that a person be terminally ill before they qualify for euthanasia in Canada, allowing those with chronic conditions and mental health problems to have their lives ended. 

'But even before this court ruling there had been problems. In July a depressed, but otherwise healthy 61-year-old man, was euthanised in the province of British Columbia. Alan Nichols, a former school caretaker who lived alone was admitted to Chilliwack General Hospital, BC. Despite not being terminally ill, he received a lethal injection. Alan's case is not isolated. 

'The problems in Canada are not unique. This summer, a major US report from the National Council on Disability, found the laws in the handful of States that had gone down this route, were ineffective and oversight of abuse and mistakes was absent. 

'This is an important report as those championing assisted suicide in this country, put forward a model based on Oregon and Washington - Yet in both States a majority of those ending their lives cite fear of becoming a burden a reason. 

'The current laws that prevent assisted suicide and euthanasia do not need changing.'

Euthanasia and assisted suicide laws give doctors, the right in law, to cause the death of their patients. 

Canada's experience with legalized assisted dying is the prime example of how these laws will expand over-time.

British Medical Association (BMA) Consultation on Euthanasia & Assisted Suicide

The following is the notice from the Care Not Killing Alliance in the UK concerning the BMA consultation on euthanasia and assisted suicide.

On Thursday 6 February, the British Medical Association (BMA) emailed all members, inviting them to respond to a consultation on 'physician-assisted dying' – which it describes as covering both assisted suicide and euthanasia, and does not limit in scope to those with terminal illnesses. Currently, the BMA is opposed to both practices, a policy reaffirmed at the 2016 annual representative meeting (ARM).

Now, 160,000 members are asked 'whether they believe the BMA should actively support, actively oppose, or neither actively support nor actively oppose (take a neutral stance on) a change in the law to permit doctors to'

• 'prescribe drugs for eligible patients to self-administer to end their own life.'
• 'administer drugs with the intention of ending an eligible patient's life.' 

Members are also asked about what has influenced their view.

The consultation runs until 27 February. It is important that as many doctors as possible respond, in the light of the evidence both against a change in the law and against a change to neutrality.

How you can get involved

• If you are a doctor, please ensure you respond. BMA members are being alerted as to how to respond by email; members yet to see such an email should check spam, or else contact the BMA if they still haven’t received an email by 11 February.
• Please discuss the issue with doctors known to you, and encourage them to support continued opposition. 
• As regards reasons to maintain opposition, you may wish to note that if legalised:

1. Vulnerable patients may feel pressure to end their lives prematurely; coercion is hard to detect.
2. Social and existential factors, not pain, drive most assisted suicides in Oregon; in 2018, 54% cited fear of being a burden. 
3. Doctors’ involvement in ending life makes it a standard (and cheaper) treatment option. 
4. Safe regulation has proved elusive and does not stop illegal practice or abuse. 

• You or others may find our overview of the consultation and the issue of neutrality helpful.
• You may wish to share our BMA campaign video on Facebook or other social media. 
• You or others may find doctors’ perspectives useful: visit or share the website of Our Duty of Care, a group of doctors who originally came together at the time of the RCP consultation last year. 

Medical neutrality would be cast by campaigners as a green light for lawmakers to weaken or repeal the laws on assisted suicide and euthanasia. In matters of life and death, where a wealth of evidence casts grave doubts on the safety and ethics of assisted suicide, doctors must maintain clarity – by maintaining opposition.

Link to more information on the BMA consultation (Link).

US Congress Resolution H.Con.Res.79: Assisted suicide puts everyone at risk of deadly harm.

(Link to the Congressional Resolution H.Con.Res.79)

Expressing the sense of the Congress that assisted suicide (sometimes referred to using other terms) puts everyone, including those most vulnerable, at risk of deadly harm.

IN THE HOUSE OF REPRESENTATIVES
December 12, 2019

Mr. Correa (for himself, Mr. Wenstrup, Mr. Peterson, Mr. Smith of New Jersey, Mr. Langevin, Mrs. Wagner, Mr. Lipinski, Mr. LaHood, Mr. Cartwright, Mr. Harris, and Mr. Abraham) submitted the following concurrent resolution; which was referred to the Committee on Energy and Commerce.

Whereas “suicide” means the act of intentionally ending one’s own life, preempting death from disease, accident, injury, age, or other condition;

Whereas “assisting in a suicide”, sometimes referred to as death with dignity, end-of-life options, aid-in-dying, or similar phrases, means knowingly and willingly prescribing, providing, dispensing, or distributing to an individual a substance, device, or other means that, if taken, used, ingested, or administered as directed, expected, or instructed, will, with reasonable medical certainty, result in the death of the individual, preempting death from disease, accident, injury, age, or other condition;

Whereas society has a longstanding policy of supporting suicide prevention such as through the efforts of many public and private suicide prevention programs, the benefits of which could be denied under a public policy of assisted suicide;

Whereas assisted suicide most directly threatens the lives of people who are elderly, experience depression, have a disability, or are subject to emotional or financial pressure to end their lives;

Whereas the Oregon Health Authority’s annual reports reveal that pain or the fear of pain is listed second to last (25 percent) among the reasons cited by all patients seeking lethal drugs since 1998, while the top 5 reasons cited are psychological and social concerns: “losing autonomy” (92 percent), “less able to engage in activities that make life enjoyable” (90 percent), “loss of dignity” (79 percent), “losing control of bodily functions” (48 percent), and “burden on family friends/caregivers” (41 percent);

Whereas the Supreme Court has ruled twice (in Washington v. Glucksberg and Vacco v. Quill) that there is no constitutional right to assisted suicide, that the Government has a legitimate interest in prohibiting assisted suicide, and that such prohibitions rationally relate to “protecting the vulnerable from coercion” and “protecting disabled and terminally ill people from prejudice, negative and inaccurate stereotypes, and ‘societal indifference’”;

Whereas clearly expressing that assisted suicide is not a legitimate health care service, Congress passed, with a nearly unanimous vote, and President Bill Clinton signed, the Assisted Suicide Funding Restriction Act to prevent the use of Federal funds for any item or service, including advocacy, provided for the purpose of causing, or assisting in causing, the death of any individual such as by assisted suicide, euthanasia, or mercy killing;

Whereas a handful of States have authorized assisted suicide, but over 30 States have rejected over 200 attempts at legalization since 1994;

Whereas States that authorize assisted suicide for terminally ill patients do not require that such patients receive psychological screening or treatment, though studies show that the overwhelming majority of patients contemplating suicide experience depression;

Whereas the laws of such States contain no requirement for a medical attendant to be present at the time the lethal dose is taken, used, ingested, or administered to intervene in the event of medical complications;

Whereas such State laws contain no requirement that a qualified monitor be present to assure that the patient is knowingly and voluntarily taking, using, ingesting, or administering the lethal dose;

Whereas such State laws contain no requirement to secure lethal medication if unwanted or if death occurs before such medication is used;

Whereas such State laws do not prevent family members, heirs, or health care providers from pressuring patients to request assisted suicide;

Whereas such States qualify some patients for assisted suicide by using a broad definition of “terminal disease” and “going to die in six months or less” that includes diseases (such as diabetes or HIV) that, if appropriately treated, would not otherwise result in death within six months;

Whereas it is extremely difficult even for the most experienced doctors to accurately prognosticate a six-month life expectancy as required, making such a prognosis a prediction, not a certainty;

Whereas reporting requirements vary by State, but when required, rely on prescribing physicians or dispensing pharmacists to self-report;

Whereas such reporting is neither conducted by an objective third party nor of sufficient depth and accuracy to effectively monitor the occurrence of assisted suicide;

Whereas there is an astounding lack of transparency in the practice of assisted suicide to the extent that State health departments and other authorities admittedly have no method of knowing if it is being practiced within the bounds of State laws and have no funding or authority to make such a determination;

Whereas some State laws actively conceal assisted suicide by directing the physician to list the cause of death as the underlying condition without reference to death by suicide;

Whereas the confidential nature of end-of-life decisions makes it virtually impossible to effectively monitor a physician’s behavior to prevent abuses, making any number of safeguards insufficient;

Whereas the cost of lethal medication is far less costly than many life-saving treatments, which threatens to restrict treatment options, especially for disadvantaged and vulnerable persons, as has happened in several known cases and presumably many more unknown in which insurers have denied or delayed coverage for life-saving care while offering to cover assisted suicide;

Whereas access to personal assistance services such as in-home hospice and palliative care, home health care aides, and nursing care/nursing assistance is regretfully limited and subject to long waiting lists in many areas, placing systemic pressure on patients in need of such personal assistance services to resort to assisted suicide; and

Whereas for all these reasons, assisted suicide undermines the integrity of the health care system: Now, therefore, be it

Resolved by the House of Representatives (the Senate concurring), That it is the sense of Congress that the Federal Government should ensure that every person facing the end of their life has access to the best quality and comprehensive medical care, including palliative, in-home, or hospice care, tailored to their needs and that the Federal Government should not adopt or endorse policies or practices that support, encourage, or facilitate suicide or assisted suicide, whether by physicians or others.

Canadian Hospice Palliative Care Leaders - Joint Call to Action.

November 27, 2019 (Link to the Joint Call to Action).

Due to ongoing confusion amongst the general public regarding Hospice Palliative Care (HPC) and Medical Assistance in Dying (MAiD), the Canadian Hospice Palliative Care Association (CHPCA) and the Canadian Society of Palliative Care Physicians (CSPCP) would like to clarify the relationship of hospice palliative care and MAiD.

Healthcare articles and the general media continue to conflate and thus misrepresent these two fundamentally different practices. MAiD is not part of hospice palliative care; it is not an “extension” of palliative care [i] nor is it one of the tools “in the palliative care basket”.[ii] National and international hospice palliative care organizations are unified in the position that MAiD is not part of the practice of hospice palliative care.[iii] [iv] [v] [vi] [vii] [viii] [ix] [x]

Hospice palliative care and MAiD substantially differ in multiple areas including in philosophy, intention and approach.[xi] Hospice palliative care focuses on improving quality of life and symptom management through holistic person-centered care for those living with life threatening conditions. Hospice palliative care sees dying as a normal part of life and helps people to live and die well. Hospice palliative care does not seek to hasten death or intentionally end life. In MAiD, however, the intention is to address suffering by ending life through the administration of a lethal dose of drugs at an eligible person’s request.

Less than 30% of Canadians have access to high quality hospice palliative care, yet more than 90% of all deaths in Canada would benefit from it.[xii] [xiii] Despite this startling discrepancy, access to hospice palliative care is not considered a fundamental healthcare right for Canadians. In contrast, MAiD has been deemed a right through the Canada Health Act, even though deaths from MAiD account for less than 1.5% of all deaths in Canada.[xiv]

We call on the federal and provincial governments to prioritize funding and improve access to hospice palliative care in Canada, and to support the implementation and action plan of the National Framework for Palliative Care in Canada.[xv] Canadians must have a right to assistance in living with hospice palliative care, and not just a right to termination of life.

Sincerely,


Sharon Baxter, MSW
Executive Director
Canadian Hospice Palliative Care Association (CHPCA)
Annex D, Saint-Vincent Hospital
60 Cambridge Street, North
Ottawa, Ontario K1R 7A5
SBaxter@chpca.net


Leonie Herx MD PhD FCFP (PC)
President
Canadian Society of Palliative Care Physicians (CSPCP)
Suite 584
1A – 12830 – 96th Avenue
Surrey, British Columbia V3V 0C2
Leonie.Herx@kingstonhsc.ca

---

[i] Buchman, Dr. Sandy. “Bringing Compassion to Medicine and to the CMA.” Canadian Medical Association, 12 Oct. 2019, https://www.cma.ca/dr-sandy-buchman.

[ii] Kutcher, Dr. Matt. “Navigating MAiD on PEI.” Canadian Medical Association, 19 Nov. 2018, https://www.cma.ca/dr-matt-kutcher.

[iii] World Health Organization (WHO). “WHO Definition of Palliative Care.” World Health Organization (WHO), https://www.who.int/cancer/palliative/definition/en/.

[iv] De Lima L, Woodruff R, et al, International Association for Hospice and Palliative Care “Position Statement Euthanasia and Physician-Assisted Suicide.” JPM Vol 20, 1:1 -7.

[v] Radbruch, Lukas, et al. “Euthanasia and Physician-Assisted Suicide: A White Paper from the European Association for Palliative Care.” Palliative Medicine, vol. 30, no. 2, 2015, pp. 104–116., doi:10.1177/0269216315616524.

[vi] Australia and New Zealand Society of Palliative Medicine (ANZSPM) “Position Statement on the Practice of Euthanasia and Physician Assisted Suicide.” 31 Mar. 2017

[vii] Canadian Hospice Palliative Care Association “Policy on Hospice Palliative Care and Medical Assistance in Dying (MAiD).” Jun. 2019

[viii] Canadian Society of Palliative Care Physicians “Key Messages: Palliative Care and Medical Assistance in Dying (MAID).” May 2019.

[ix] “Statement on Physician-Assisted Dying.” American Academy of Hospice and Palliative Medicine (AAHPM), 24 Jul. 2016, http://aahpm.org/positions/pad.

[x] Canadian Medical Association. “Palliative Care (Policy).” 2016

[xi] Shariff M & Gingerich M. “Endgame: Philosophical, Clinical and Legal Distinctions between Palliative Care and Termination of Life.” Vol. 85, Second Series Supreme Court Law Review 225. 2018

[xii] Quality End-of-Life Care Coalition of Canada and Canadian Hospice Palliative Care Association. “The Way Forward National Framework; a Roadmap for an Integrated Palliative Approach to Care.” Mar. 2015.

[xiii] Canadian Society of Palliative Care Physicians . “How to Improve Palliative Care in Canada - A Call to Action for Federal, Provincial, Territorial, Regional and Local Decision-Makers.” Nov. 2016.

[xiv] “Fourth Interim Report on Medical Assistance in Dying in Canada.” Government of Canada, Health Canada, Apr. 2019, https://www.canada.ca/en/health-canada/services/publications/health-system-services/medical-assistance-dying-interim-report-april-2019.html.

[xv] “Framework on Palliative Care in Canada.” Government of Canada, Health Canada, 4 Dec. 2018, https://www.canada.ca/en/health-canada/services/health-care-system/reports-publications/palliative-care/framework-palliative-care-canada.html.

Psychiatrists Must Prevent Suicide, Not Provide It

Alex Schadenberg
Executive Director, Euthanasia Prevention Coalition

Psychiatrists Cynthia Geppert, Mark Komrad, Ronald Pies and Annette Hanson are leading voices against the involvement of Psychiatrists in the acts of euthanasia and assisted suicide. 

During the past several months there have been a series of articles and rebuttles between Geppert, Komrad, Pies and Hanson with Drs Kious and Battin. Dr Margaret Battin is a long-time euthanasia activist who has published articles and studies since the 1980's.

The recent rubuttal with Kious and Battin was published in the Psychiatric Times on November 19, 2019. The recent Geppert et al response concerns the following:

Kious and Battin argue that the long-established practice of psychiatrists to make every effort to prevent suicide including the use of involuntary commitment and the relatively new availability of physician aid-in-dying (PAD) create a moral dilemma. Their proposed resolution of the dilemma is to permit psychiatric patients, as well as those with medical illnesses, to access PAD when their suffering is severe and irremediable. Our commentary rejects the fundamental presumption that any physicians, much less psychiatrists, should be involved of the work of killing rather than the calling of healing, among other criticisms.

Cynthia Geppert

Kious and Battin argue that the majority of Americans support assisted suicide, but Geppert et al suggest that polling alone does not determine right or wrong, that in fact a deep analysis of the issue is necessary. Geppert et al argue that the research by the American Medical Association, the World Medical Association and more enables a better understanding of the issues. They state:

This “deep dive” is precisely the process that was brought to bear by the American Medical Association (AMA) and the World Medical Association (WMA) in their recent reexaminations of their ethical opposition to these practices.4 That process was repeated several times at the request of PAS proponents, and each time, though acknowledging the caring intentions on both sides of the issues, these organizations kept coming to the same conclusion—that these practices are “firmly opposed.” Similarly, for the second largest medical organization in the US—the American College of Physicians5—and even for the organization that works professionally in the “end-zone” of life—the International Association for Hospice and Palliative Care6—these and other articulations, are not mere polls. They are robust deliberations by organizations representing physicians and others, whom society is asking to do the killing. Moreover, no medical organization in the US has actually endorsed PAS as a laudable practice so far. At most, those organizations not opposed to PAS have expressed official “neutrality” on this issue.

Kious and Battin argue that Geppert et al hold to a position of essentialism and historicism, which they suggest changes over time. Geppert et al respond:

We now turn to Drs Kious and Battins’ critique of our philosophical position as “essentialism” and “historicism.” If by “essentialism,” they mean that we hold certain medical ethical truths to be constant, enduring, and not “will-o-the-wisp” notions dependent on polls and plebiscites, then, yes—we are guilty of “essentialism.” While we would acknowledge that “evolving social expectations” do have some influence on “what is permissible for physicians,” we would deny that such expectations are infinitely elastic and determinative, vis-à-vis what is ethically permissible. Would the authors change their own position favoring “assisted dying” if new polls showed that most physicians oppose the practice? Or do they base their position in favor of PAS on their own view of what is “essential” to the role of physicians? If we make medical ethics dependent upon polls, we are opening the field to a kind of post-modern relativism that undercuts the very concept of a “profession.” Medical ethics are not a kind of weather vane, changeable with each new poll that comes out! We would argue that PAS is really an outgrowth of, and is contemporaneous with, the consumer movement of the past 50 to 60 years and is therefore an anomaly in the history of medical ethics.7 

Ronald Pies

Geppert et al then defend Hippocratic medicine:

It is not the literal wording of the Hippocratic Oath, but the subsequent development of those values that has provided a moral compass for the medical profession. That growth, intellectually and experientially, resembles, for example, the development of religious values, not confined to, but inspired by the esteemed teachers and holy books of the world’s great religious traditions. These are evolving and venerable moral compasses for covenantal communities. The current Tree of Medicine is rooted in its Hippocratic soil. It has ramified branches of thoughts and values yet embodies a core ethos that has persisted through the rise and fall of many societies.

Annette Hanson

They then challenge the attack that they are simply historicists:

Our colleagues should not so easily dismiss the lessons of history as mere “historicism.” We believe very much in Santayana’s famous wisdom:  “Those who cannot remember the past are condemned to repeat it.” Changing social mores and highly popular notions, championed by celebrities, intellectuals, and policy makers, have swept physicians off their ethical moorings in the past. Consider the historic example of Soviet psychiatry. Civil commitment was used to isolate dissidents, and the doctors went along with it. Physicians, especially psychiatrists, participated with relish in eugenics-inspired forced sterilization programs of the mentally ill in the US.8 There are moral absolutes that our profession should stand up for, in spite of legislative or popular pressure. Public health policy should not be contingent upon popularity. Many popular ideas were proved both wrong and harmful (eg. conversion therapy for homosexuals).

They conclude their rebuttal by referring to anthropologist Margaret Mead:

Anthropologist Margaret Mead presciently warned a physician friend about the social pressure on physicians to kill in the name of mercy, observing that:

The followers of Hippocrates were dedicated completely to life under all circumstances, regardless of rank, age, or intellect—the life of a slave, emperor, foreign man, defective child . . . This is a priceless legacy which we cannot afford to tarnish. But society has repeatedly attempted to make the physician into the killer . . . It is the duty of society to protect the physician from such requests.9

We would do well to heed her warning.

I am sure that this debate will continue. Geppert, Komrad, Pies and Hanson hold to the truth, that physicians must not kill their patients and psychiatrists prevent suicide, not provide it.

Dr Geppert is Professor of Psychiatry and Medicine, and Director of Ethics Education, University of New Mexico School of Medicine; and Ethics Section Editor of Psychiatric Times. Dr Komrad is on the psychiatry faculty of Johns Hopkins, University of Maryland, and Tulane University. Dr Pies is Professor Emeritus of Psychiatry and Lecturer on Bioethics & Humanities, SUNY Upstate Medical University; Clinical Professor of Psychiatry, Tufts University School of Medicine; and Editor-in-Chief Emeritus of Psychiatric Times (2007-2010). Dr Hanson is Director of the Forensic Psychiatry Fellowship at the University of Maryland.
References:

1. Kious BM, Battin MP. Physician Aid-in-Dying and Suicide Prevention in Psychiatry: A Moral Crisis? Am J Bioeth. 2019;19:29-39.

2. Magelssen M, Supphellen M, Nortvedt P, Materstvedt LJ. Attitudes towards assisted dying are influenced by question wording and order: a survey experiment. BMC Med Ethics. 2016;17:24.

3. Dany L, Baumstarck K, Dudoit E, et al. Determinants of favourable opinions about euthanasia in a sample of French physicians. BMC Palliat Care. 2015;14:59.

4. World Medical Association. WMA Declaration on Euthanasia and Physician-Assisted Suicide. https://www.wma.net/policies-post/declaration-on-euthanasia-and-physician-assisted-suicide. Accessed November 7, 2019.

5. Snyder L, Sulmasy DP, Ethics, Human Rights Committee ACoP-ASoIM. Physician-assisted suicide. Ann Intern Med. 2001;135:209-216.

6. De Lima L, Woodruff R, Pettus K, et al. International Association for Hospice and Palliative Care Position Statement: Euthanasia and Physician-Assisted Suicide. J Palliat Med. 2017;20:8-14.

7. Pies RW. Physician-Assisted Suicide and the Rise of the Consumer Movement. Psychiatric Times. 2016;33(8). https://www.psychiatrictimes.com/couch-crisis/physician-assisted-suicide-and-rise-consumer-movement. Accessed November 18, 2019.

8. Dowbiggen I. Keepin America Sane: Psychiatry and Eugenics in the United States and Canada, 1880-1940. New York: Cornell University Press; 2003.

9. Mead M. The Hippocratic Registry of Physicians. https://www.hippocraticregistry.com. Accessed November 18, 2019.

Conscience protection rules struck down by US federal judge.

Alex Schadenberg
Executive Director, Euthanasia Prevention Coalition

A federal judge in New York  struck down protections in law for medical professionals who conscientiously object to assisted suicide. 

Doctors may be forced to refer patients for assisted suicide.

When discussing the issues of euthanasia and assisted suicide with medical professionals, the issue of conscience protection is always a concern. 

Physicians who believe that it is wrong to kill patients by lethal injection or prescribing lethal drugs have lost, today, clear conscience protection.

In May 2019, the Trump administration announced an order to protect conscience rights for healthcare workers. CNBC reported:

In a release last week, the Health and Human Services announced the issuance of its final “conscience” rule, which it said follows President Donald Trump’s May 2017 executive order and his pledge “to promote and protect the fundamental and unalienable rights of conscience and religious liberty.”

Today, a federal U.S. District Judge Paul Engelmayer struck down the Trump administrations conscience rule that protected medical professionals from participating in medical procedures that they consider to be immoral or simply wrong.

The Trump conscience rule protected medical professionals from participating in many medical activities including euthanasia and assisted suicide.

According to an article by Stephanie Armour who's article was published in the Wall Street Journal:

Nineteen states and family planning groups had sued to block the Department of Health and Human Services regulation that sought to expand enforcement of protections for medical workers with moral or faith-based objections to medical procedures such as abortion, assisted suicide or sterilization at hundreds of thousands of health organizations.

Armour reported New York Attorney General, Letitia James as stating:

“The refusal of care rule was an unlawful attempt to allow health-care providers to openly discriminate and refuse to provide necessary health care to patients based on providers’ ‘religious beliefs or moral objections,’

The Trump administration must appeal this decision based on a false understanding of the role of health care providers. Doctors should not be forced to participate in legal healthcare services that many healthcare professionals morally object to, such as assisted suicide.

The courts and government should not have the right to force someone to participate in an act that the person considers morally objectionable. Physicians refuse to participate in capital punishment. In the same manner many physicians refuse to participate in assisted suicide.

California 2018 assisted suicide report. 337 reported assisted suicide deaths.

Alex Schadenberg
Executive Director, Euthanasia Prevention Coalition

The 2018 California annual assisted suicide report is similar to other US jurisdictions were the report implies that the assisted suicide deaths were voluntary and self administered, but the information in the report does not address that subject.

Order the pamphlet - Shedding light on assisted suicide in America.

The California assisted suicide data is based on the reports from the doctors who carry-out the assisted suicide death. It is not possible, based on the reporting system, to uncover abuse of assisted suicide or uncover under-reported deaths.

According to the 2018 California assisted suicide report:

• 452 prescriptions for lethal drugs were written resulting in 314 reported assisted suicide deaths. 
• There were 23 reported assisted suicide deaths from lethal drugs prescribed in 2017.
• There were 337 reported assisted suicide deaths in 2018.
• There were 59 deaths from the underlying illness or other causes and 79 people where the death status was unknown.

There may be more assisted suicide deaths. Some of the 79 people who's status is unknown, may have died by assisted suicide.

Since assisted suicide was legalized on June 9, 2016, there have been 807 reported assisted suicide deaths. There were 374 reported assisted suicide deaths in 2017.

On May 15, 2018, Life Legal Defense successfully challenged California's assisted suicide law with Judge, Ottolia, overturning the California assisted suicide law by ruling that the legislature acted outside the scope of its authority when it enacted the End of Life Option Act in 2015. 

On Friday, June 15, the Fourth District Court of Appeals in Riverside County California, issued a stay of the assisted suicide law, overturning the decision of Judge Ottolia to once again permit doctors in California to assist the suicide of patients.

Since assisted suicide was prohibited in California for several weeks in 2018, I anticipate that the number of assisted suicide deaths will increase substantially in 2019.

Recently a nurse plead not guilty to murder, in a California court, based on her allegedly injecting her friend with assisted suicide drugs. The case will be heard next year, but this case shows how lethal drugs can be used to kill someone outside of the law.

In December 2017, a former California politician, Steven Clute, was charged with assisting the suicide of his wife, Pamela, in August 2016.

World Medical Association: Euthanasia is unethical.

This article wass published by OneNewsNow on October 31, 2019.

Alex Schadenberg

Some medical groups are unhappy with the World Medical Association (WMA) and its position on doctor-assisted suicide, and the Euthanasia Prevention Coalition says the subsequent split is probably for the best.

In spite of intense pressure, the WMA has reaffirmed its position against medical professionals helping patients kill themselves. Alex Schadenberg of the Euthanasia Prevention Coalition is pleased with the development.

“They made it very clear that these things are not within ethical healthcare," Schadenberg reports. "They also provided a new definition of euthanasia and assisted suicide, which [is] good because it makes the debate very clear to physicians what they are talking about."

The document also protects the conscience rights of physicians who object to the practice, which is important because doctors are being pressured into participating.

Still, not all doctor groups are pleased.

"The Dutch Medical Association and the Canadian Medical Associations have both left the World Medical Association because they feel that the WMA doesn't represent them," the Coalition head tells OneNewsNow. "Maybe the best thing for the WMA is to have these groups leave because they were only pressuring them to do something which was wrong."

The American Medical Association this year likewise reaffirmed its position against doctors helping their patient kill themselves, in spite of heavy pressure to change their policy.

Christian, Jewish and Muslim. Declaration against Euthanasia and Assisted Suicide.

On October 28, leaders of the Christian, the Jewish and the Muslim faiths signed a Declaration against Euthanasia and assisted suicide. (Link to the Position paper and Declaration).

Based on the arguments and justifications articulated in this position paper, the three Abrahamic monotheistic religions share common goals and are in complete agreement in their approach to end-of-life situations. Accordingly, we affirm that:

➢ Euthanasia and physician-assisted suicide are inherently and consequentially morally and religiously wrong and should be forbidden with no exceptions. Any pressure upon dying patients to end their lives by active and deliberate actions is categorically rejected.

➢ No health care provider should be coerced or pressured to either directly or indirectly assist in the deliberate and intentional death of a patient through assisted suicide or any form of euthanasia, especially when it is against the religious beliefs of the provider. It has been well accepted throughout the generations that conscientious objection to acts that conflict with a person’s ethical values should be respected. This also remains valid even if such acts have been accepted by the local legal system, or by certain groups of citizens. Moral objections regarding issues of life and death certainly fall into the category of conscientious objection that should be universally respected.

➢ We encourage and support validated and professional palliative care everywhere and for everyone. Even when efforts to continue staving off death seems unreasonably burdensome, we are morally and religiously duty-bound to provide comfort, effective pain and symptoms relief, companionship, care and spiritual assistance to the dying patient and to her/his family.

➢ We commend laws and policies that protect the rights and the dignity of the dying patient, in order to avoid euthanasia and promote palliative care.

➢ We, as a society, must assure that patients’ desire not to be a burden does not inspire them the feeling of being useless and the subsequent unawareness of the value and dignity of their life, which deserves care and support until its natural end.

➢ All health care providers should be duty-bound to create the conditions by which religious assistance is assured to anyone who asks for it, either explicitly or implicitly.

➢ We are committed to use our knowledge and research to shape policies that promote socio-emotional, physical and spiritual care and wellbeing, by providing the utmost information and care to those facing grave illness and death.

➢ We are committed to engage our communities on the issues of bioethics related to the dying patient, as well as to acquaint them with techniques of compassionate companionship for those who are suffering and dying.

➢ We are committed to raising public awareness about palliative care through education and providing resources concerning treatments for the suffering and the dying.

➢ We are committed to providing succor to the family and to the loved ones of dying patients.

➢ We call upon all policy-makers and health-care providers to familiarize themselves with this wide-ranging Abrahamic monotheistic perspective and teaching in order to provide the best care to dying patients and to their families who adhere to the religious norms and guidance of their respective religious traditions.

➢ We are committed to involving the other religions and all people of goodwill.